Objective: This study aimed to quantify primary healthcare service deficits in Western Türkiye by comparing accessibility with capacity-adjusted coverage for Family Health Centers (FHCs), identify optimal, equity-focused locations for new FHCs using capacity-aware location-allocation modeling; and present a validated, reproducible Geographic Information Systems (GIS) based framework applicable to diverse national contexts.Method: Observational geographic analysis.
GIS, location-allocation modeling, and joinpoint regression were applied across 11 Western Türkiye provinces. Accessibility, based on a 15-minute walking threshold was evaluated first. Coverage was then recalculated, incorporating FHC capacity, which is defined as a maximum of 2,500 people per Family Physician Unit.
A scale-up analysis identified optimal locations to achieve 70% capacity-constrained coverage. Joinpoint regression assessed facility expansion efficiency.Results: While potential 15-minute walking accessibility appeared high in urban centers (e.g., Bursa 73.4%, İzmir 72.6%), enforcing capacity constraints drastically reduced effective coverage (e.g., Bursa 49.4%, İzmir 50.4%), revealing an average coverage gap exceeding 20 percentage points and exposing severe service pressure.
Profound deficits were observed in rural districts (